Provider Demographics
NPI:1083646426
Name:WHEELCHAIRS NORTHWEST, LTD
Entity Type:Organization
Organization Name:WHEELCHAIRS NORTHWEST, LTD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:WENDELL
Authorized Official - Middle Name:G
Authorized Official - Last Name:MATAS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:425-646-4601
Mailing Address - Street 1:1600 124TH AVE NE STE A
Mailing Address - Street 2:
Mailing Address - City:BELLEVUE
Mailing Address - State:WA
Mailing Address - Zip Code:98005-2132
Mailing Address - Country:US
Mailing Address - Phone:425-646-4601
Mailing Address - Fax:425-462-1195
Practice Address - Street 1:1600 124TH AVE NE STE A
Practice Address - Street 2:
Practice Address - City:BELLEVUE
Practice Address - State:WA
Practice Address - Zip Code:98005-2132
Practice Address - Country:US
Practice Address - Phone:425-646-4601
Practice Address - Fax:425-462-1195
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-07
Last Update Date:2009-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA601342163332B00000X, 332BC3200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized Equipment
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA0371010001Medicare NSC